Md. Code Regs. 32.02.01.13 – Application for Renewal Certificate of Registration.

A. The provider shall file an application for a renewal certificate of registration within 120 days of the end of the provider's fiscal year on a form provided by the Department.
B. A renewal certificate of registration shall be issued for 1 year, which is in effect from 6 months after the end of the provider's most recent fiscal year to 6 months after the close of the provider's current fiscal year.
C. The application for a renewal certificate of registration shall include the following information and attachments:
1. (1) Any changes or additions to the information submitted on the most recent application;
2. (2) An original certified financial statement for the preceding fiscal year prepared in accordance with generally accepted accounting principles, which include the principles expressed in the American Institute of Certified Public Accounts' “Audit and Accounting Guide for Health Care Organizations”;
3. (3) All exhibits or attachments to the certified financial statements, including:
  1. (a) A balance sheet,
  2. (b) An income statement,
  3. (c) A statement of cash flows,
  4. (d) The related notes to the financial statements, and
  5. (e) The opinion of an independent certified public accountant;
4. (4) An operating budget for the current fiscal year prepared in accordance with generally accepted accounting principles;
5. (5) A projection of the number of subscribers who will require nursing home care and an estimate of the life expectancy of future subscribers;
6. (6) A projected operating budget for the next succeeding fiscal year prepared in accordance with generally accepted accounting principals;
7. (7) An actuarial study which meets the requirements of §E of this regulation;
8. (8) A report specifying:
  1. (a) The total current number of units,
  2. (b) Whether each unit is occupied or unoccupied, and
  3. (c) Changes in unit configurations proposed for the succeeding year;
9. (9) A copy of each current license and certificate required to be issued by MDH or the Department;
10. (10) A copy of the provider's most recent certificate of need or exemption letter from MHCC;
11. (11) The form and substance of any advertising campaign or proposed advertisement and other promotional materials not previously filed with the Department;
12. (12) A renewal fee of $29 per unit;
13. (13) A cash flow projection for the current fiscal year and the next 2 fiscal years prepared in accordance with generally accepted accounting principles;
14. (14) A statement that provides the dates of the meetings held the previous year to comply with Regulation .19 of this chapter;
15. (15) A copy of the disclosure statement prepared in accordance with Regulation .21 of this chapter; and
16. (16) A statement that indicates compliance with the operating reserve requirement in Regulation .20 of this chapter.
D. Actuarial Study Exceptions.
1. (1) Until January 1, 1999, §E of this regulation does not apply to facilities which offer only domiciliary care or comprehensive care and do not offer independent living units.
2. (2) Section E of this regulation does not apply to a facility:
  1. (a) Where the only health care provided to subscribers is either priority admission to an independent nursing facility or paid for on a fee-for-service basis;
  2. (b) Where:
    1. (i) The provider is in the process of decertifying as a provider; and
    2. (ii) Fewer than five of the facility's subscribers have continuing care agreements that promise the provider will provide more than 90 days of nursing care on a basis other than fee-for-service; or
  3. (c) Where:
    1. (i) The comprehensive care facility is Medicaid certified;
    2. (ii) The continuing care agreements presently offered new subscribers only provide nursing care on a fee-for-service basis, and
    3. (iii) 5 percent or less of the facility's subscribers have continuing care agreements that promise the provider will provide nursing care on a basis other than fee-for-service.
E. Actuarial Study.
1. (1) Unless exempted by §D of this regulation, every 3 years after occupancy of the facility has begun, a provider shall submit to the Department with its renewal application an actuarial study, prepared or reviewed by a qualified actuary. The actuarial study shall include:
  1. (a) An actuarial balance sheet for current subscribers;
  2. (b) A cohort pricing analysis for a cohort of new subscribers; and
  3. (c) Projected cash and investment balances for a period of 20 years.
2. (2) The actuarial study required by §E(1) of this regulation shall be performed in accordance with generally accepted actuarial principles and the standards of practice adopted by the Actuarial Standards Board of the American Academy of Actuaries. The actuarial study shall include or be accompanied by a statement of the opinion of a qualified actuary as to whether:
  1. (a) The data and assumptions used are appropriate;
  2. (b) The methods employed are consistent with sound actuarial principles and practices;
  3. (c) Provision has been made for all actuarial liabilities and related statement items; and
  4. (d) The provider is in satisfactory actuarial balance.
3. (3) The actuarial study shall include supporting detailed documentation, including a projection of future population flows and health care bed needs for 20 years using appropriate inflation factors, mortality, morbidity, withdrawal, and other demographic assumptions.
4. (4) The Department may request the information required in §E(1)—(3) of this regulation more frequently to assist in the determination of possible financial difficulty as provided in Regulation .26 of this chapter.
F. If the materials required in §C of this regulation are not received in the Department within 120 days after the end of the provider's fiscal year, the Department may charge a late fee of $10 per unit in addition to the renewal fee per unit, unless a written request for an extension is submitted to and approved by the Department within the 120-day period.
G. Failure to file the annual renewal application or obtain an extension within 120 days after the end of a fiscal year is a violation of the Act and this chapter.

Authority: Human Services Article, §10-403, Annotated Code of Maryland

Effective date: December 26, 1980 (7:26 Md. R. 2423)

Regulations .02B, .04A, .08, .10, and .14 amended effective March 28, 1983 (10:6 Md. R. 559)

Regulations .04A, .05A, .06, and .09 amended effective December 31, 1984 (11:26 Md. R. 2280)

Regulation .07 repealed and new Regulation .07 adopted effective December 31, 1984 (11:26 Md. R. 2280)

Regulations .01—.22 repealed and new Regulations .01—.22 adopted effective June 2, 1986 (13:11 Md. R. 1274)

Regulation .01B amended effective December 1, 1989 (16:23 Md. R. 2506); November 25, 1991 (18:23 Md. R. 2491)

Regulation .03A amended effective December 1, 1989 (16:23 Md. R. 2506); September 23, 1996 (23:19 Md. R. 1377)

Regulation .03B and C amended effective November 25, 1991 (18:23 Md. R. 2491)

Regulation .04A amended effective November 25, 1991 (18:23 Md. R. 2491)

Regulation .09 amended effective November 25, 1991 (18:23 Md. R. 2491)

Regulation .09C amended effective December 1, 1989 (16:23 Md. R. 2506); June 22, 1992 (19:12 Md. R. 1136); September 23, 1996 (23:19 Md. R. 1377)

Regulation .09E amended effective December 1, 1989 (16:23 Md. R. 2506)

Regulation .09G amended effective June 22, 1992 (19:12 Md. R. 1136)

Regulation .10A amended effective November 25, 1991 (18:23 Md. R. 2491)

Regulations .01—.22 repealed and new Regulations .01—.36 adopted effective July 27, 1998 (25:15 Md. R. 1192)

Chapter recodified from COMAR 14.11.02 to COMAR 32.02.01, October 2000

Regulation .01B amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .02B amended effective October 6, 2008 (35:20 Md. R. 1777)

Regulation .02B, E amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .03B amended effective March 1, 2004 (31:4 Md. R. 318)

Regulation .04 amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .05A amended effective November 6, 2006 (33:22 Md. R. 1734); March 22, 2010 (37:6 Md. R. 481)

Regulation .06L, M amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .07A amended effective March 22, 2010 (37:6 Md. R. 481)

Regulation .07A, B amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .09B amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .10A amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .11B amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .12D amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .13 amended effective October 6, 2008 (35:20 Md. R. 1777); March 22, 2010 (37:6 Md. R. 481)

Regulation .13C amended effective March 1, 2004 (31:4 Md. R. 318); March 4, 2013 (40:4 Md. R. 348); August 29, 2016 (43:17 Md. R. 959)

Regulation .13C, F amended effective March 17, 2025 (52:5 Md. R. 239)

Regulation .13D amended effective December 25, 2000 (27:25 Md. R. 2283)

Regulation .14 amended effective March 22, 2010 (37:6 Md. R. 481)

Regulation .17E amended effective March 1, 2004 (31:4 Md. R. 318); June 20, 2016 (43:12 Md. R. 668)

Regulation .19 amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .20 amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .21C amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .22C amended effective March 17, 2025 (52:5 Md. R. 239)

Regulation .23D amended effective March 17, 2025 (52:5 Md. R. 239)

Regulation .23G amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .24B, H amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .25 amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .26 amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .27A, C amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .28C amended effective March 22, 2010 (37:6 Md. R. 481)

Regulation .28A, E amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .28F adopted effective March 22, 2010 (37:6 Md. R. 481)

Regulation .29 amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .32B amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .34C amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .35B amended effective November 6, 2006 (33:22 Md. R. 1734)

Regulation .36 amended effective March 17, 2025 (52:5 Md. R. 239)